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ARCHIVED REPORTS_XR0005034
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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983
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2900 - Site Mitigation Program
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PR0507952
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ARCHIVED REPORTS_XR0005034
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Entry Properties
Last modified
9/16/2020 1:00:43 AM
Creation date
3/17/2020 2:09:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005034
RECORD_ID
PR0507952
PE
2950
FACILITY_ID
FA0007846
FACILITY_NAME
OLYMPIAN CFN
STREET_NUMBER
983
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
APN
22115006
CURRENT_STATUS
01
SITE_LOCATION
983 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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• <br /> M min M M M M = M m4r M <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc 2 � ° > � � Date Page <br /> 837 Shaw Road- Stockton, California 95215- (209) 467-1006 Fax (209) 467-1118 <br /> Client �C S Project Manager ! � Tests Required <br /> a- <br /> Phone Number 5 <br /> Samplers (Signature) V Invoice <br /> Project Name ! AGE,] <br /> 7 Client ❑ <br /> Sample Location Sample e <br /> Date Time Sample <br /> Sajid No of Noses <br /> Number DescriptionCompafab Air Conts <br /> r <br /> -M-05 <br /> rytw 3 a � ld t 1 <br /> -_82307__-- __-- <br /> <03r,o <br /> 82309 <br /> a rnq s ad by ( nature) <br /> DalafT ma <br /> -AeIktqvMed by gna e) Received b SI nature f b <br /> y � g } � Data(Time <br /> Relinquished b (Signature)q y { g } Received b 6Sobrte Laboratory for field analysis Si nature � <br /> Y Y Y ( g ) � � � Date(rrme <br /> Dispatched by (Signature) Date/Time Received for Le oratory b atelTima <br /> Method of Shipment TAS TA[v OT! boratory Name <br />` Special instructions NUOD CONDJTJPN� ill,�f4`tll ereby authors ]he performance of the above indicated work <br /> r �� <br />
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